This is a subjective question. And also depends on the infrastructure you are in control of.
With MX records you can channel your destination only a bit. The randomization is left out to the DNS or even the client. They should spread it evenly but they also sometime cache the randomization for future requests. So you rely on the client side or intermediate DNS that they hopefully load balance for you.
The same goes for the A records. You do not control how the client side interprets the DNS answer. Will they behave as you expect? Do they follow the RFCs? Do they randomize or always start with the first one? You are not in control.
If you have multiple servers behind one IP in a HA cluster, then you are in control. You know how to load balance the incoming traffic, based on load or other criteria. But your bottleneck will be the bandwidth to the border machine which distributes the traffic.
So you can combine everything as you like. Do you need multiple data centers to receive mail in case of a failure, then one IP is not enough. Do you control the DNS and can give realtime geographical-local answers to a data center near the sender? Can you live with semi load balanced traffic by the sender?
Look at Google. They give you five MX (at the time of writing) but everyone has a different priority. Each MX has only one A/AAAA. But the answers are short lived (TTL), so that "everytime" you request the IP you get a different one. And I'll bet you that behind every IP there are dozens of real servers answering the clients. And I would also guess that these answers are geocoded to reach a data center on at least the same continent. You probalby know that Google has thousands of servers handling billions or trillions of mails per day. Definitively not with five MXs with increasing priorities. And I will not argue with them. Their staff has a higher pay grade than me.